11 - Adverse reactions to Iodinated Contrast Media

Abstract

Iodinated contrast media (CM) are routinely used to enhance imaging of neoplastic lesions. They are crucial for accurate depiction of the tumor, monitoring response to treatment, and assessing possible recurrence of malignant lesions. Unfortunately, there are potential risks associated with the administration of CM, and adverse reactions may occur. In addition, CM may interact with some of the drugs and clinical tests used in the management of patients with oncological disease. Reactions to CM can be divided into general and renal adverse effects. General reactions are subdivided into acute (those that develop within one hour of CM administration) and delayed (those that develop after one hour but less than a week after CM administration). Acute reactions can be divided into minor, intermediate, and severe life-threatening reactions. The minor reactions include flushing, nausea, arm pain, pruritus, vomiting, headache, and mild urticaria. Patients suffering from reduced renal function or conditions causing reduction of renal perfusion may develop contrast media nephrotoxicity (CMN). Consideration should be given to alternative imaging techniques that do not require injection of iodinated CM. The use of gadolinium-based CM has been suggested for radiographic examinations as an alternative to iodinated CM in patients with renal impairment. Contrast media may interfere with the pharmacokinetics of other drugs, particularly those that are eliminated from the body through the kidneys. Iodinated contrast media can cause reduction of renal function, particularly in patients with preexisting reduced renal function.